Monday Morning Update 5/8/23

Top News

UC San Diego Health will use a $22 million donation to create a mission control center for digital medical data.

The health system notes that many systems issue constant streams of potentially useful data, which requires experts and AI to isolate the elements and trends that would be immediately useful to caregivers.

The donation and the plan to develop the center were announced in February 2023. They were explained further in last week’s Innovation in Digital Health symposium.

HIStalk Announcements and Requests

I’m relieved that poll results suggest that I’m not the only one who has zero interest in sitting through videos and podcasts that were made at HIMSS23. I’m feigning anticipation of the educational session recordings, but I know from past years that my interest drops off quickly in the weeks it takes for them to be posted.

New poll to your right or here: Has your employer cut back on remote work in the past year? I drew the ire of several readers in July 2022 when I said this:

Economic and industry conditions have put bosses back in charge and they know that they need to manage costs while fretting less that their employees might flee to greener pastures … I bet many executives agree with me that you can’t build and maintain a great company when employees are doing task work in their living rooms … I expect companies to compromise by offering a hybrid model of 1-2 offsite work days per week or maybe going with a permanent four-day workweek.

GLP-1 weight loss drugs such as Wegovy and Ozempic are fascinating, especially as they negatively affect the work of physicians. Insurers don’t want to pay for them, so they are adding bureaucratic measures to impede demand, such as prior authorization and documentation proving that less expensive alternatives were tried and failed. Second, patients who cannot afford to pay $800 to $1,500 per month will pressure their doctors to falsely diagnose them with diabetes so their insurance will pay, which could land the doctors in trouble in the absence of supporting clinical documentation. The US is a weight loss drug dream market of overweight people (two-thirds of the population), lobbyist-friendly politicians, and unregulated drug pricing, and while these drugs might improve an individual’s health, our system of frequent job and insurance changes doesn’t reward employers and insurers who spend money today to save someone else on healthcare expenses years from now. And we like drugs better than behavioral changes, as the now-shuttered Jenny Craig can attest.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.

Acquisitions, Funding, Business, and Stock

Shares of the Global X Telemedicine and Digital Health ETF were unchanged over the past month versus the SP& 500’s 1% gain. They are down 25% since inception in July 2020 versus the S&P’s 26% gain. Top holdings are Masimo, Doximity, Alibaba, JD Health, and DexCom. 

Minnesota’s largest employer, Mayo Clinic, threatens to redirect billions of its investment dollars to other states in protest of two bills that would: (a) set a maximum patient-to-nurse staffing ratio; and (b) create a Health Care Affordability Board that would set healthcare spending growth targets, enhance provider transparency, and explore alternative payment programs.

People

Nym promotes Or Peles to CEO. He replaces co-founder Amihai Neiderman, who will remain on the company’s board.

Announcements and Implementations

Redox announces its reimagined product portfolio: Nexus (integration); Nexus Lite (a lightweight, self-service offering); Access (connection to Carequality and DirectTrust); Chroma (a Verato-powered EMPI); and Nova (transform legacy standards to FHIR using existing provider integrations and libraries).

Toronto’s Women’s College Hospital incorporates Indigenous healing and wellness practices into Epic.

A new KLAS report on hospice software finds that MatrixCare and WellSky are ranked highest for independent hospices, while Epic Comfort is top ranked overall by its hospital-owned hospice users.

Government and Politics

The Senate Finance Committee wants to hold health plans accountable for “ghost networks,” citing a secret shopper study by Senate staffers in which only 18% could get an appointment with a mental health provider that was listed by 12 Medicare Advantage plans. Another audit of MA plans found that 73% of dermatologists who were listed as in-network providers could not be booked for an appointment due to duplicate entries or a change in plans they accept. 

Kell West Regional Hospital, which was one of just four hospitals that CMS fined for failing to comply with its price transparency rule, will appeal the $117,000 fine because it has successfully met CMS requirements after a company it had hired failed to deliver.

Privacy and Security

The ALPHV group of ransomware hackers say they have breached Constellation Software, whose software groups include healthcare-focused Harris Computer, and are threatening to publicly post 1 TB of its data if it fails to pay the ransom. Constellation, which has acquired 500 software companies since 1995, says it has restored its infrastructure and none of the IT systems of its companies was affected. An ALPHV ransomware attack took down the Colonial Pipeline in May 2021, triggering panic buying that caused gasoline shortages in the eastern US even though the company paid the demanded $4.4 million almost immediately. 

Other

Don Detmer, MD, MA and Andrew Gettinger, MD list essential EHR reforms for the this decade in a JAMA viewpoint article in which they also advocate use of technology such as ambient voice recognition, AI, and cloud-based medication and allergy lists.:

• Develop a national patient identifier as HIPAA originally mandated.
• Remove administrative and regulatory content from clinical time. CMS should replace check-the-box documentation by deriving quality measures from existing documentation.
• Include patient-entered information in the EHR.
• Reinvent the clinical note to become prospective and to encourage less documentation instead of more. Ban copy-paste and copy-forward functions.

Scan Health President and CEO Sachin Jain, MD, MBA says in a Forbes opinion piece that health systems have “an epidemic of inauthenticity and superficial execution” as much-publicized projects are never scaled beyond pilots or limited deployment, broken care processes are hidden, and regression to the mean is presented as evidence of impact. He adds that we have normalized inauthenticity as being good salesmanship, as people are selling their ideas and building their brands despite lack of real impact, which will eventually breed cynicism and burnout. 

Danielle Ofri, MD, PhD observes “The Curious Side Effects of Medical Transparency” in a New Yorker essay, where she ponders how her practice has changed due to Cures Act requirements that patients be given access to clinician documentation:

• She worries that patients will become alarmed if she records her differential diagnosis correctly and they see serious but unlikely possible diagnoses that she is ruling out.
• She cites experts who question whether transparency should be its own ideal or whether it should be compared with other ways to deliver the same end result.
• Seniors whose technology is managed by their adult children have asked her to keep some prescriptions private, and having multiple family members accessing the patient’s portal can make it hard to determine whether communications are going to them directly or to detect when patient records are being accessed by people who are harming them.
• The use of multi-test lab panels almost ensures that every patient will get a slightly out-of-range result that will be highlighted as abnormal, or the results of tests whose result can’t be expressed as a simple yes or no.
• She spends time every day managing a flood of patient questions about new test results and is forced to try to answer urgent questions quickly without having completed basic legwork.

Sponsor Updates

• Wolters Kluwer Health staff in Waltham, MA clean up the banks of the Charles River as part of its Green is Green initiative.
• Drug Store News recognizes OmniSys XiFin Pharmacy Solutions for the second time with its annual Retail Excellence Award – Technology and Automation.
• An OptimizeRx physician survey finds that they are receiving life sciences product information from a variety of channels, but with gaps, and with a need for more information about treatment eligibility, affordability, and access.
• Sectra releases a new episode of its Let’s Talk Enterprise Imaging Podcast, “Beyond the technology – how Sectra provides end-to-end SaaS security.”
• Black Book Research names Andor Health to the top spot in virtual care collaboration solutions based on a survey of nearly 1,000 health system executives.
• KLAS awards Ellkay its Points of Light award, recognizing the company’s payer-provider collaboration efforts via bi-directional connectivity. 
• National Medical Care Company in Saudi Arabia selects Wolters Kluwer Health’s UpToDate, UpToDate Advanced, and Medi-Span solutions.
• First Databank VP of Clinical Network Services Lathe Bigler will present at the NCPDP 2023 Annual Technology & Business Conference May 9 in Scottsdale, AZ.

Blog Posts

• Will AI help healthcare systems fight against disintermediation? (Nordic)
• Managing Alert Fatigue – an Alarming Problem! (Optimum Healthcare IT)
• Next-Best Action: Elevating the Future of Omnichannel HCP Marketing (OptimizeRx)
• Healthcare Coding Series: SNOMED CT (Pivot Point Consulting)
• How Better Communication Management Ensures Top of License Practice (PerfectServe)
• The Complexities of Behavioral Health Billing (PMD)
• AI’s stretch towards the last mile (Nordic)
• Missouri Health System Increases Provider Engagement with PINC AI Stanson (Premier)
• HCC Model v28 Proposed Changes: Opposing Viewpoints (RCxRules)
• Post-pandemic HIMSS v1.0 – 2023’s event unwrapped (Redox)
• Reaching Peak Healthcare Interoperability Together One Step at a Time (Surescripts)
• All about the people: Transforming care with the UVM Health Network (Tegria)
• Is healthcare home to the next wave of AI innovation? What to consider as the industry weighs the potential impact of AI on the patient experience. (Upfront Healthcare)
• The Federal Breast Density Inform Rule: Huge Leap Forward, But More to Do (Volpara Health)
• 11 Google Business Profile Tips to Dominate Local SEO (WebPT)
• Tackling Rising Denial Rates in 2023 (Vyne Medical)

Contacts

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